Devices & Technology

Mobile Health Care Moves Beyond the Cell Phone

September 16, 2011 - When most of us think about mobile technology, the first device that likely comes to mind is our cell phone, a communication tool that emerged to allow us to talk to each other while on the go, but has evolved into so much more. Today it is something most people--including health care providers--can’t leave home without.

When it comes to mobile health care technology (mHealth), however, cell phones are just the beginning. Today’s mobile tools--and those coming down the pike--put health care in the hands of the provider and the consumer in ways never before seen.

“The biggest application is the electronic medical record [EMR], particularly on the iPad, which is becoming the most important mHealth platform in clinical settings in the United States,” explained Jody Ranck, Ph.D., directory of thought leadership, policy and advocacy for the mHealth Alliance, based in Washington, D.C. “You can access patient records, radiographic records and even do better patient education with some of the visualization tools that are being developed for tablets with high resolution screens. A growing number of clinical support tools, such as ePoctrates, are in use for clinicians, and the number of patient-focused apps has grown steadily as well, reaching nearly 17,000 for iPhones and iPads.”

Ranck added that the potential benefits of mHealth tools are different but numerous for both patients and providers.

“For patients, the biggest value-add is in the range of tools to manage chronic diseases such as diabetes and obesity, as well as interesting apps for asthma, pediatrics and general wellness,” he said. “Trackers that promote and sustain behavioral change, as well as social games that take advantage of social networks and incentives to promote behavior change, are also becoming more popular.”

For providers, however, the focus is more on efficiency, cost and the reduction of medical errors.

“When you combine mobile platforms with cloud computing, it enables things like health information exchanges, which make the continuity of care across geographies more efficient and convenient for both patient and provider,” Ranck continued. “Overall the benefits should be in cost savings, improved quality of care through continuity and more efficacious self-care.”

In addition to benefiting the overall health care landscape, mHealth technology also has the ability to make positive changes in specific areas of interest and need.

“As the name implies, mobile health enables proactive care to be provided to patients where they are, when they need it,” says Nicole K. Boramanand, MSN, MBA, vice president of clinical systems innovation for West Wireless Health Institute, a San Diego, California-based nonprofit organization dedicated to lowering health care costs by accelerating the availability of wireless health solutions.

Boramanand specifies home health as an area that is poised to see a great benefit from new and emerging mHealth tools.

“As our population ages with a broad constellation of co-morbid conditions, such as congestive heart failure [CHF], COPD and diabetes, being able to manage patients in their home in a way that empowers them toward self-care and prevents emergency room visits and hospitalizations will not only reduce health care cost, but also improve the quality of life for patients and families,” she said.

Using CHF as an example, Boramanand highlights particular mHealth tools that cater toward the care of the condition.

“CHF patients discharged home can use simple devices to measure biometric parameters of interest, thus enabling home health nurses to better treat the individual and improve operational efficiency,” she explained. “Additionally, patch-based devices that measure multiple biometrics can be used to assess when a patient has been adequately diuresed following an acute decompensation event, enabling clinicians to more clearly identify when a patient is ready for discharge.”

One such patch-based device, recently developed by researchers at the University of Illinois Urbana-Champaign, is applied in a similar fashion as a temporary tattoo and serves to monitor body processes in a noninvasive, practically invisible way. John Rogers, professor of materials science and engineering, led a team of engineers to create the innovative technology, known as epidermal electronics.

“We are interested in forms of electronics that look, in the sense of mechanics and shape, like biological tissues,” he explained. “We have worked in the past on devices that integrate with the surfaces of the heart and brain. The skin is a particularly interesting organ and an excellent location for non-invasively mounting electronics--a skin-like or epidermal form of electronics integrates with the skin in a simple way that does not constrain natural motions of the tissue. The result is a mechanically invisible integrated system, capable of monitoring body processes.”

The clinical applications of Rogers’ technology can serve as attractive alternatives to conventional electrode interfaces for EKG, EMG, EEG and other related monitoring devices, he said.

“In the future, however, we envision this technology as ubiquitous and worn in a continuous mode to provide health and wellness monitoring at all times, outside of hospital settings,” Rogers said.

The monitoring and management of health outside of hospital walls is part of what makes mHealth applications and technologies so appealing, empowers patients to take control of their health care, and allows providers increased access to real-time information that improves care, quality and efficiency--and it’s where health care of the future is heading.

“Just as we’ve seen patients embracing information technologies to be better informed about their conditions, we could see more patient demand for different technologies,” Ranck added. “Overall, the practice of health care is becoming more data driven with patients as our partners.”